Benchmarking lung cancer mortality rates in current and former smokers Journal Article


Authors: Bach, P. B.; Elkin, E. B.; Pastorino, U.; Kattan, M. W.; Mushlin, A. I.; Begg, C. B.; Parkin, D. M.
Article Title: Benchmarking lung cancer mortality rates in current and former smokers
Abstract: Study objectives: To develop and validate a model for estimating the risk of lung cancer death in current and former smokers. The model is intended for use in analyzing a population of subjects who are undergoing lung cancer screening or receiving lung cancer chemoprevention, to determine whether the intervention has altered lung cancer mortality. Design/setting/patients: Model derivation was based on analyses of the placebo arm of the Carotene and Retinol Efficacy Trial. Model validation was based on analyses of three other longitudinal cohorts. Measurements: Observed and predicted number of deaths due to lung cancer. Results: In internal validation, the model was highly concordant and well calibrated. In external validation, the model predictions were similar to what was observed in all of the validation analyses. The predicted and observed deaths within 6 years were very similar when assessed in the Johns Hopkins Hospital trial of chest radiography and sputum cytology screening (176 predicted, 184 observed, p = 0.53), the Memorial Sloan-Kettering Cancer Center trial of chest radiography and sputum cytology screening (108 predicted, 114 observed, p = 0.57), and the National Health and Nutrition Evaluation Survey part I (24 predicted, 21 observed, p = 0.52). Conclusions: The number of lung cancer deaths in a population of current or former smokers can be accurately predicted, making model-based evaluations of prevention and early detection interventions a useful adjunct to definitive randomized trials. We illustrate this potential use with a small example.
Keywords: adult; controlled study; aged; aged, 80 and over; middle aged; survival rate; major clinical study; validation process; quality control; chemoprophylaxis; logistic models; lung neoplasms; risk factors; cancer screening; lung cancer; smoking cessation; smoking; prediction; cancer mortality; risk assessment; death; thorax radiography; ct; sputum cytodiagnosis; humans; human; male; female; priority journal; article
Journal Title: Chest
Volume: 126
Issue: 6
ISSN: 0012-3692
Publisher: American College of Chest Physicians  
Date Published: 2004-12-01
Start Page: 1742
End Page: 1749
Language: English
DOI: 10.1378/chest.126.6.1742
PROVIDER: scopus
PUBMED: 15596668
DOI/URL:
Notes: Chest -- Cited By (since 1996):24 -- Export Date: 16 June 2014 -- CODEN: CHETB -- Source: Scopus
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MSK Authors
  1. Colin B Begg
    306 Begg
  2. Elena B Elkin
    163 Elkin
  3. Peter Bach
    255 Bach
  4. Michael W Kattan
    218 Kattan